Data Use Authorization

By checking this box, I certify that I understand that I have provided personal information in order to express interest in a voluntary property acquisition (home buyout) program and that I have willingly provided this information. I consent that my name and the information provided in this form may be used by Buy-In Community Planning, Inc. to develop a buyout program in my area. In the event that funding is identified, my survey responses will be used to contact me to ask if I am interested in participating. I understand that my participation in any buyout or acquisition project is entirely voluntary and can be withdrawn at any time.

All information collected in this intake form is kept private and confidential unless required by law or granted with your express permission in the case of a buyout program becoming available, in which case we will contact you directly before information is shared. Electronic records of the information you provide are collected on encrypted devices, transmitted in encrypted form, and stored permanently on secure servers. The risks associated with this survey are minimal and you will not be compensated for participating. This agreement, a copy of your survey responses, and info about this project is available upon request by emailing info@buy-in.org